(1) Field of the Invention
The present invention pertains to a tool designed to hold an aneurysm clip and to be manually activated by a surgeon to apply the clip to a blood vessel in the brain. In particular, the present invention pertains to pliers adapted to hold and apply an aneurysm clip on a blood vessel wherein the pliers have a small dimension adjacent the aneurysm clip so as to be capable of projecting through a small opening in the skull of a patient.
(2) Prior Art
Conventional clip appliers for aneurysm clips are simplistic in design and limited in function with respect to their ability to apply an aneurysm clip. Generally, prior art clip appliers consisted of an elongated handle portion at the end opposite the clip retaining end. These clip appliers operated on a scissors-type principle so that when the elongated handle portion is squeezed together, the clip applier ends pivot about a rivet or axle and approach one another. When an aneurysm clip is positioned between the clip ends and the handle portion is squeezed together, the aneurysm clip opens so that it may be applied to a blood vessel by a surgeon. These scissor-type clip appliers have been in existence a long time and little to no progress has been made in their design. Moreover, because the design is very simplistic, it is limited in its application in that a surgeon must contort his hand, wrist and arm in order to apply the clip on a blood vessel in a difficult or remote location. Often, contortion of the surgeon's hand, wrist and arm cause the surgeon to lose manual dexterity resulting in the clip being applied incompletely or improperly. Furthermore, the contortion of the surgeon's hand, wrist and arm often block the surgeon's view of the blood vessel to which the clip is to be applied. In order to aid the physician in obtaining access to a remotely located blood vessel, conventional aneurysm clips often were available in which the contact portion of the clip is angled with respect to the remainder of the clip. However, these type of aneurysm clips could only alleviate the contortion of the surgeon's hand, wrist or arm in one direction.
Another common problem with conventional aneurysm clip appliers is that the tool is spring biased completely open. This requires the physician or surgeon to load the aneurysm clip within the applier, rather than having a tray with several clip appliers loaded with an aneurysm clip. If an applier were fully loaded and ready to use, a nurse could hand the applier to the surgeon when desired.
Conventional aneurysm clip appliers are illustrated in the Codman Surgical Instrument Catalog, pages 329-335. The following U.S. patent references further illustrate the aneurysm clip applier.
U.S. Pat. No. 2,876,778 to Kees, issued on Mar. 10, 1959, discloses a scissors-type aneurysm clip applier which is spring-biased open. Each free end of the applier is hooked so that a clip may be retained between the hooked ends. A plate enables a clip to be placed between the hooked ends and retained in such a position until the surgeon is ready to apply the clip to a blood vessel. Although this aneurysm clip applier circumvents one of the previously described problems, it is not capable of alleviating any contortion of the hand, wrist or arm of a surgeon.
U.S. Pat. No. 4,241,734 to Kandel et al issued on Dec. 30, 1980, discloses a shackle with a tubular member mounted on the shackle. A rod with a clip grip is inserted into the tubular member. The clip is pulled by the rod into the tubular member which opens the clip. The rod is axially forced back out the tubular member to permit the clip to close. While this device has small dimensions adjacent the end of the tubular member, thereby utilizing a small hole in the brain, it does not alleviate any contortion of the hand, wrist or arm of the surgeon.
None of these conventional type clip aneurysm appliers is movable in a multitude of directions without the physician or surgeon contorting his or her hand, wrist or arm. None of the conventional clip aneurysm appliers include a mechanism for loading, retaining and applying an aneurysm clip which is not in alignment with the longitudinal axis of the appliers. Moreover, the conventional aneurysm clip appliers are designed to lie flat in one's hand and therefore are difficult to rotate in one's hand due to the planar portion of the elongated handle means and are not comfortably balanced as contrasted with an object having a rod-type hand grip.